| NPI | 1043262363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NH 22365) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX L2123) |
| 207T00000X Neurological Surgery (Licence: VA 0101040652) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-02-08 |